Permit CITY OF TIGARD PLUMBING PERMIT
•1111 COMMUNITY DEVELOPMENT Permit#: PLM2015 00231
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/21/2015
Parcel: 25112 DA01000
Jurisdiction: Tigard
Site address: 6610 SW CARDINAL LN
Project: Umpqua Bank Subdivision: 1995-098 PARTITION PLAT Lot: 1
Project Description: Add(1)lay,(1)water closet,(1)ice maker,relocate(1)breakroom sink.
Contractor: ALLIANT SYSTEMS LLC Owner: PACIFIC REALTY ASSOCIATES
1600 NW 167TH PL#330 ATTN: N PIVEN
BEAVERTON, OR 97006 15350 SW SEQUOIA PKWY#300
PORTLAND,OR 97224
PHONE: 503-619-4066 PHONE: 503-624-6300
FAX: 503-230-9238
FEES
Quantity Description Date Amount
1 ea Ice Maker 07/21/2015 $12.51
Specifics: 1 ea Sink 07/21/2015 $25.02
1 ea Lavatories 07/21/2015 $25.02
Type of Use: COM 1 ea Water Closet 07/21/2015 $25.02
Class of Work: ALT 1 12%State Surcharge- 07/21/2015 $10.51
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $98.08
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Noti ••• enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dir-• questions to •. C b calling 503.232.1987 or 1.800.332.2344.
Issued By: I (11/W-41-61 Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Si Accumulative Sewer Tally
Tenant Name: Umpqua Bank SWR# 2015-00092
Site Address: 6610 SW Cardinal Lane 131,M # 2015-00231
Parcel#: 2S 112DA01000
Fixture \.110, Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value total#s total values
Baptisery/Font 4 0 0 0 0 0
Bath: -Tub/Shower 4 0 0 0 0 0
-Jacuzzi/Whirlpool 4 0 0 0 0 0
Car Wash: -Each Stall 6 0 0 0 0 0
-Drive through 16 0 0 0 0 0
Cuspidor/Water Aspirator 1 0 0 0 0 0
Dishwasher: -Commercial 4 0 0 0 0 0
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Hoot Drain/Sink: -2 inch 2 0 0 0 0 0
-3 inch 5 0 0 0 0 0
-4 inch 6 0 0 0 0 0
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 HP) 16 0 0 0 0 0
-Commercial(to 5 HP) 32 0 0 0 0 0
-Industrial(over 5 HP) 42 0 0 0 0 (1
Ice Machine/Refrigerator Drain 1 0 0 0 0 (I
Living Unit 16 0 0 0 0 0
Oil Sep(Gas Station) 6 0 0 0 0 (I
Rec.Vehicle Dump station 16 0 0 0 0 0
Shower. -Gang(per head) 1 0 0 0 0 (I
-Stall 2 0 0 0 0 0
Sink:
-I,av/Bar-Non-Food Related 2 0 0 1 2 1 2
-Bradley 5 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 0 0 0 0
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 0 1 6 1 6
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 2 8 2 8
Current Fixture Value 8 divided by 16= 0.500 Current EDU 1 EDU= $5,100.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 8 divided by 16= 0.500 over (under) $ 2,550.00
Enter EDU Change Here 0.500 *
*Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01.
Notes:
Authorized Name/Signature: Debbie Adamski Date: 7/21/2015
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:\Building\Sewer Tally\Sewer I'allySheet_5100_070115.xlsx
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
6610 SW CARDINAL LN, TIGARD, OR, 97224
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2015-00231
George Heimos
1 could not detect any hot water at tempering valve. Provide hot water. 502.5
2. Recall inspection when correction has been completed. Re-inspection required.
103.5.6.1
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
6610 SW CARDINAL LN, TIGARD, OR, 97224
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00231
George Heimos
Violation Summary:
Inspector Contractor